Local City Search for Psychiatrists, Psychologists, Therapists, Counselors and Mental Health Treatment CentersLESLIE JAY SUGA PHD HSPP
Clinical Neuropsychologist
Indianapolis, Indiana
Provider NPI: 1972595684
Provider Information:LESLIE JAY SUGA PHD HSPP
Gender: M
Not Sole Proprietor
Practice Location:
6515 E 82ND ST SUITE 210 INDIANAPOLIS, IN 46250 US
Tel: 317-559-0990 Fax: 317-653-6405
Business Mailing Address:
8539 TIDEWATER DR INDIANAPOLIS, IN 46236 US
Tel: -- Fax: --
Entity Type: Individual
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | IN | 20040349A |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 100376990A | IN | 05 | |
| MEDICARE RAILROAD | 680013641 | IN | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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